Laserfiche WebLink
CPG # TO: t'FICE OF REVENUE AND RECOVERY 4ft OV <br /> pN /� <br /> ACCOUNT TRANSMITTAL 0 D <br /> ACCOUNT NO. DEPT.NO. REDAT <br /> FERRAL <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> INLAND FLYING SVC <br /> C/O NAME GUARANTOR SSN <br /> WALTER CHEERS <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 2050 E SIKORSKY STOCKTON CA 95206 209-982-1102 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 209-982-1102 <br /> USER REFERENCE NO. BILL STA CYCLE STATUS DATE BMd CBMC INT MONTHLY PAY AMT <br /> 1950 HAZMAT I I I I I I I I I I I I I 1 1 4/15/04 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENTnnR USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NO <br /> 230 026000.0 2004 Hmmp Annual Fee $240.00 <br /> 1 Chem @ $15.00 $15.00 <br /> 10% Late Charge $25.50 <br /> State Service Fee $24.00 <br /> TOTAL $304.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> INLAND FLYING SVC 209-982-1102 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2050 E SIKORSKY STOCKTON CA 95206 <br /> ffileUSB CO—OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB OR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> INLAND FLYING SVC 209-982-1102 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2050 E SIKORSKY STOCKTON CA 95206 <br /> 1 1 .PREPARED BY. t&e_Z1 CHECKED BY 4Ztay�Q DATE &11'710161 coy. 20 ryes <br />